The overall goal of the proposed study is to understand how the organization and financing of outpatient drug abuse treatment units affect the ability to provide services that meet desired standards of care. We have gathered information on five key aspects of treatment services and practices: (1) access to care; (2) quality assurance efforts; (3) the range and intensity of medical and social services units provide; (4) length of treatment; and (5) the cost of care. With this information, we can assess how well the nation's outpatient treatment units are meeting known or desired standards of care. For example, to what extent are units providing mental health care for clients with psychiatric co-morbidities (Woody, McLellan, O'Brien & Luborsky, 1991)? To achieve the above goal, we will meet two specific aims: (1) First, we will conduct a secondary analysis of data from a nationally representative panel (i.e., 1988 and 1990) of 475 outpatient treatment units. This analysis will focus on the relationship between several organizational factors that previous research indicates account for significant variation in treatment practices and the five key aspects of treatment noted above. The specific organizational factors we will focus on are: ownership, funding, staffing, location, referral sources, licensing, treatment philosophy, and client characteristics. (2) Second, we will focus a new wave (1994-95) of data collection and analysis on the impact of a particular set of organizing and financing arrangements, known as managed care," on key aspects of treatment. "Managed care" is a general term that refers to several different types of arrangements for financing and organizing health care. Many managed care plans have responsibility for: establishing criteria for patient assessment and care management; recruiting and organizing treatment providers; and negotiating contracts with payers and providers. It is clear that these plans to finance and shape treatment are emerging as a critical feature of the organization of drug abuse treatment units (Woodward, 1992). The proposed study will not only identify what types of managed care arrangements outpatient units are encountering, but also how these arrangements are affecting key treatment practices.